Bottom Hospital sits in the old trading center portion of Lilongwe Town, a short distance from the big mosque, and just east of the Lilongwe River. Highway M-1 passes a block to the north and the visitor passing through town may miss it entirely. It must have derived its name because it sits at the bottom of the valley, but one must wonder if its name is symbolic of being at the bottom of some sort of an imaginary list. It is a montage of mismatched buildings, some of them beige, while others are a dirty weather beaten off white. A much larger group buildings are a brownish orange color that mimics the ground on which the decrepit facility rests. Bars on most of the windows bemoan the realization of the amount of petty crime and theft that is rampant in many parts of this tiny nation nestled in one of the deepest pockets of poverty in the sub-Sahara. In spite of all of the efforts to control the problem it is still rampant in an “everyone does it” attempt at justification by those who cannot find a way to stop it. Almost everything can and does disappear from the medical facilities in time. And this includes not just the “small stuff”. It goes all the way to actually including mattresses and beds.
Spotted along the dusty footpaths and broken pavement outside the buildings are the nurses who are coming and going in spotlessly white uniforms that defy the surroundings in which they work. They appear at duty stations with a manifestation of purity, cleanliness and commitment that dare the believer to understand, when they are seen in the environment in which they must work. One need only to watch them in their harsh and unpleasant environment in order to gain a new respect for the nursing profession as it is being played out in the harsh surroundings of poverty stricken Africa. One would be hard pressed to explain how a nurse can enter the workday in a white uniform, and end the day with it still appearing white and spotless.
Minor Gains Against Major Problems
Today the hospital looks much different than it did even one year ago. Fresh paint can be found in some of the wards. This is progress even though old, chipped paint still holds the count for supremacy. Old beds and mattresses still outnumber newer ones. But there is some gain. One can see a gallant effort that is showing some results that is gaining a toehold in the battle against death, disease and despair. The staff is gaining one inch at a time. Nurses do not handle as many deliveries per shift as they were doing just a year ago, although the patient to nurse ratio is still at unbelievably high levels that shake any western nurse all the way down to her spotlessly white nursing shoes. To the question of “how can they give good heath care to patients when the patient load is so high” comes the dreadful, but honest and candid answer of, “they can’t!”
The Untrained Care for the Patients
There are not enough nurses in the hospitals so an untrained family member must always come with the patient in order to provide for their care. Read the rest of this entry »
